Consultees?? Concordance with Consultants?? Recommendations for Diagnostic Action

Abstract

Consultees'' concordance with psychiatric consultants'' recommendations for diagnostic action was studied retrospectively. Of 381 initial consultations reviewed, 110 (29%) contained 1 or more recommendations for diagnostic action. Consultees'' responses were rated concordant in only 53% of these cases. This disturbing outcome, reflecting broad resistance to consultants'' practice of making recommendations for diagnostic action, is attributed to consultees'' use of a functional category is argued to be perceived by consultees as a nonmedical entity. As the psychiatrist is invoked to deal with this nonmedical entity, he is seen in other than the medical mode and inconsistently afforded medical privilege. The work implies how wide the gap to medical credibility may be for psychiatric consultants and the need for new consultation strategies incorporating this cognizance.